Article Figures & Data
- Figure 1
Rectus crush, abdominal injuries, femur fracture and traumatic brain injury. (A) Rectus abdominis separated from skin and subcutaneous tissue, exposing 5 cm of the muscle and crushed with a Kelly clamp to create a soft tissue injury. (B) Section of spleen 5 cm from its distal tip is transected sharply. Remaining spleen is oversewn to prevent excess blood loss. (C) Left median lobe of liver transected sharply 5 cm from its anterior tip. Cut edge of liver is allowed to hemorrhage freely for 30 seconds before being closed by oversewing the cut edge, cauterizing the surface, and packing with laparotomy pads. (D) 3 cm injury created in the sigmoid colon 10 cm proximal to the anterior peritoneal reflection, exposing fecal matter. The colotomy in left open. (E) Small cruciate incision is used to cut down onto the lateral femur. Femur fractured with .22 caliber bullet using a captive bolt gun, creating a long bone fracture. 4×4 gauze pads are placed into wound after fracture to prevent excess bleeding. (F) Close-up of the bolt gun used. (G) A 21 mm burr hole was made just anterior and to the right of the bregma to expose the dura for traumatic brain injury. A 5 mm burr hole was made anterior and left of the bregma for placement of an intracranial pressure monitor. (H) Controlled cortical impact device set up to deliver a 12 mm impact.
- Figure 2
Experimental timeline. Invasive lines were placed (cannulation), followed by rectus muscle, bone, liver, spleen and colon injuries, then hemorrhage and traumatic brain injury (TBI). Animals were left in shock for 1–2 hours, depending on the model (survival animals had 2-hour shock, all other animals had 1-hour shock). Then treatment began with normal saline resuscitation given over 1 hour. Autologous packed red blood cells (pRBC) were given 2 hours after resuscitation. Concurrent with pRBC transfusion, the laparotomy was reopened; the colon injury was repaired and abdomen irrigated with normal saline; and antibiotics were administered. The animal was then monitored for an additional 4 hours at which point the experiment was ended for non-survival models.
- Figure 3
Kaplan-Meier survival curves. X-axis shows hours since start of traumatic injuries.
- Figure 4
Physiologic parameters. Heart rate (HR) in beats per minute (BPM), mean arterial pressure (MAP) in mm Hg, cardiac output (CO) in liters per minute (L/min) and central venous pressure (CVP) in mm Hg. X-axis shows hours since start of traumatic injuries.
Supplementary Materials
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Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
